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PERMIT APPLICATION <br />BUILDINGIMECHANICAL/PLUMBING(SIGN/SPRINKLER/DEMOLITION <br />CITY OF EVERETT PERMIT SERVICES (i y / �— <br />32011 Cedar St., Everett, WA 98201 - 425-257.8810 — FAX 425-257-8857 — www.everattwa.oyr§§ <br />c <br />AYYLIVHIIV n�nn�n..vu <br />otc <br />.. <br />n FROM a AM TO d PM <br />... <br />PROPERTY TAX II PERI'VT{fC, _O <br />SITE ADDRESS: l� LV r 0- I L lJC— <br />,\' 'll <br />LEGAL for new construclicn: Short PlaUsubdivislon Lot No. (attach copy of long legal description) <br />OWNER Phone/E-mail <br />Address 1 L _ O Cilyl5late/Zip <br />CONTRACTOR L 8 I Lic. # ai 0 <br />PhoneJEmail <br />Address <br />TENANT BUSINESS NAME CONTACT FOR PERMIT d <br />PhonalE-mall li t` C z);,0 „o O C <br />BUILDING PERMIT APPLICATION CONTRACT PRICE OF WORK 00 <br />HEAT SOURCE: <br />Existing Use of Building <br />Ga i Eleclri:_ _ Other <br />Proposed Use o uilding <br />Building type: Single Family _ Duplex —Townhouse Multi -Family _Commercial <br />Type of project: _ New _Addition _ Remodel __ Repair _ <br />_ T.I. _ Sign Sprinkler_Demolition_Change of Use <br />Description of Work (additional space provided on the back) : <br />Have you started working without a permll7 _YES _NO <br />MECHANICAL PERMIT APPLICATION PLUMBING PERMIT APPLICATION <br />Type cf Protect: _New_Addn —Alteration _—Repair Type of Project: _New <br />_.Ada)ol O_Alteration _Repalr <br />Show Number (Is) of fixtures Show Number Toilet <br />A/C— air handling units Bathtub <br />Forced airs stems <br />Gas pipin2 Lavatory wash basin) <br />Water heater Shower <br />Gas fire lace Kitcheset <br />n sink &ills o <br />Gas ran a Dishwasher <br />Clotheser Clothes washer <br />R-1 a hood Water healer <br />Exhaust fan Sink servicelbar/mo /etc. <br />Heat pump Sacki preventer <br />Unit healer Urinal <br />Boiler Drinking Fountain <br />Refrigeration Floor drain <br />Woodslove Grease trap <br />Uuctin Roof drains <br />Other __ Medical Gas <br />SPRINKLER I SUPPRESSION SYSTEM other: <br />Number of Heads Other: <br />I hereby certify that I have read and examined this application and knew the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The granting of a permit does net presume to give authority to violate or cancel <br />the provision of any other stale or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to p orm the work for w=signal <br />PI cationmade and 1 comply with the Stale Contractors Law 18.27 RCW and 206.200 WAC <br />Own Aut ror zed Ager f uro <br />al (Revised 212011) <br />I hereby certify that I have read and examined this application and knew the same to be true and correct. All provisions of laws and ordinances governing <br />this type of work will be complied with whether specified herein or not. The granting of a permit does net presume to give authority to violate or cancel <br />the provision of any other stale or local law regulating construction or the performance of construction. That I am authorized by the owner of this property <br />to p orm the work for w=signal <br />PI cationmade and 1 comply with the Stale Contractors Law 18.27 RCW and 206.200 WAC <br />Own Aut ror zed Ager f uro <br />al (Revised 212011) <br />